In Reply: Dr Nichol and Drs Byrnes and Kelly correctly point out that persons in our study had considerably fewer total lost workdays due to influenzalike illness during the winter months than persons included in the inactivated influenza vaccine study by Nichol et al.1 However, our results were similar to those found among health care worker placebo recipients in a study by Wilde et al2 and in a multicenter randomized study of live attenuated influenza by Nichol et al.3 Thus, results found in our study, which were consistent over 2 years, are unlikely to be an aberration. Furthermore, the number of lost workdays per illness in our study were very similar to that of Nichol et al1 (0.56-0.84 days per illness vs 0.87 days per illness, respectively). The overriding difference between our study and that by Nichol et al was that the influenza-attributable illness rate was more than 3 times higher in the study by Nichol et al.